How Is Postherpetic Neuralgia Diagnosed
Postherpetic neuralgia is usually diagnosed based on your symptoms, history of having shingles and physical exam. If youve had a recent case of shingles and have pain in the area where the shingles rash once was, you likely have PHN. Your provider may want to make sure your pain is not caused by something else, but in most cases, no other tests are needed.
Who Is At Risk Of Getting Postherpetic Neuralgia
Factors that increase the risk of developing postherpetic neuralgia include:
- Older age: The chance of developing postherpetic neuralgia increases with age. If youre older and develop shingles, youre more likely to develop PHN and have longer lasting and more severe pain than a younger person with shingles. About 10 to 13% of people over age 50 who have had shingles will get PHN. People under age 40 rarely get PHN.
- Weakened immune system: Your immune system weakens as you get older, which allows the inactive varicella-zoster virus to become active again and cause shingles in some people. Medical conditions that can weaken your immune system include cancer, chronic infectious diseases , being an organ transplant recipient or taking medications that weaken your immune system .
- Severity of your shingles: If you have a severe rash, you have a greater chance of PHN.
- Painful, itchy or tingly feeling before shingles rash: If you had these symptoms in an area of skin a few days before your shingles rash broke out, you are at higher risk of PHN.
- Waiting to see your healthcare provider after shingles rash: If you wait longer than three days after your rash appeared missing the window to receive antiviral drugs you have an increased chance of PHN.
Can I Prevent Shingles
Receiving the shingles vaccine is the most effective way of preventing shingles. It is advisable to get the shingles vaccine if you:
- are over the age of 50 years
- have previously had chickenpox
- do not remember whether or not you have had chickenpox
Contact your doctor to discuss getting the shingles vaccine.
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Check If You Have Shingles
The first signs of shingles can be:
- a tingling or painful feeling in an area of skin
- a headache or feeling generally unwell
A rash will appear a few days later.
Usually you get the shingles rash on your chest and tummy, but it can appear anywhere on your body including on your face, eyes and genitals.
The rash appears as blotches on your skin, on 1 side of your body only. A rash on both the left and right of your body is unlikely to be shingles.
How Long Can Shingles Last Without Medication
Without medication, blisters typically scab over within seven to ten days, clearing completely by two to four weeks later. Symptoms can arrive before an outburst, but also continue to remain after the redness and blistering subside.
Medication is optional for people suffering from shingles, but its often a welcome reprieve from the complications of the condition. Still, some medication can prolong shingles outbreaks if a person is allergic or suffers other side effects from any dosage.
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What Are The Risk Factors For Internal Shingles
Many of the risk factors for internal shingles are the same as those for the skin rash of shingles. They include:
- Having a weakened immune system. Diseases and conditions such as HIV/AIDS, organ transplant, and autoimmune conditions like lupus, rheumatoid arthritis, or inflammatory bowel disease can make you more susceptible to shingles.
- Undergoing cancer treatment. Cancer, along with radiation and chemotherapy, also weaken your immune system and can increase your risk of a herpes zoster infection.
- Being older than 60. Shingles can occur in people of any age. However, its more common in older adults. About half the cases of shingles develop in people over 60 .
- Taking certain medications. Drugs that lower your chance of rejecting an organ transplant or treat autoimmune diseases will increase your risk of shingles. Examples include cyclosporine and tacrolimus . Extended use of steroids will also increase your risk. These medications suppress your immune system, making your body more vulnerable to infection.
Not receiving the shingles vaccine will also increase your chances of getting the condition. Even if you dont remember ever having chickenpox, you should get the shingles vaccine. Studies have shown that 99 percent of people over 40 have had chickenpox. According to the
What Can I Do For The Pain
To help with the pain of shingles, your doctor might have you take an over-the-counter pain medicine. This could include acetaminophen or ibuprofen .
Applying a medicated anti-itch lotion to the blisters might reduce the pain and itching. Placing cool compresses soaked in water mixed with white vinegar on the blisters and sores might also help.
If shingles causes severe pain, your doctor might prescribe a stronger pain medicine.
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Urgent Advice: Get Advice From 111 As Soon As You Suspect Shingles
You might need medicine to help speed up your recovery and avoid longer-lasting problems.
This works best if taken within 3 days of your symptoms starting.
111 will tell you what to do. They can arrange a phone call from a nurse or doctor if you need one.
Go to 111.nhs.uk or .
Get an urgent GP appointment
A GP may be able to treat you.
Ask your GP surgery for an urgent appointment.
How Long Does It Take For Shingles To Progress
Shingles progresses into blisters over three to five days and begins to crust over after seven to ten days. The rash is preceded by a prodromal phase lasting 48-72 hours or longer, consisting of throbbing pain and numbness in the area affecting the nerve. Once the rash blisters, it can last another three to five days before the lesions scab over.
After the lesions crust over, it may take two to four weeks to heal completely. At this time, pain may still be present. The most painful stage of shingles is when you have fluid-filled blisters. This usually occurs three to five days after the rash first appears.
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Who Is At Risk For Getting Shingles
People who have had chickenpox who are more likely to develop shingles include those:
- With a weakened immune system .
- Over the age of 50.
- Who have been ill.
- Who have experienced trauma.
- Who are under stress.
The chickenpox virus doesnt leave your body after you have chickenpox. Instead, the virus stays in a portion of your spinal nerve root called the dorsal root ganglion. For the majority of people, the virus stays there quietly and doesn’t cause problems. Researchers aren’t always sure why the virus gets reactivated, but this typically occurs at times of stress.
How Is It Treated
It is best to start treatment as soon as possible after you notice the rash. See your healthcare provider to discuss treatment with antiviral medicine, such as acyclovir. This medicine is most effective if you start taking it within the first 3 days of the rash. Antiviral medicine may speed your recovery and lessen the chance that the pain will last for a long time.
Your provider may also recommend or prescribe:
- medicine for pain
- antibacterial salves or lotions to help prevent bacterial infection of the blisters
- corticosteroids
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Who Should Get The Shingles Vaccine
The Centers for Disease Control and Prevention says you should get a shingles vaccine if you:
- Are an adult aged 50 and older
- Have never had shingles
- Have had shingles before
- Aren’t sure whether you’ve had chickenpox
- Have been previously vaccinated with the Zostavax shingles vaccine
- Are age 19 or older and are immunodeficient or immunosuppressed because of disease or therapy
Can I Give Shingles To Others
No one can catch shingles from you. But the virus can be spread to a person who has never had chickenpox. The virus lives in the blisters that shingles causes. It can be spread until the blisters are completely healed. If you have blisters that have not crusted over yet, you should stay away from:
- Anyone who has never had chickenpox
- Babies under 12 months old
- Very sick people
Tell your doctor if you live with children who have not had chickenpox. They may need to be vaccinated.
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Who Is At Risk For Shingles
About 1 in 3 Americans will develop shingles in their lifetime, according to the Centers for Disease Control and Prevention . Cases are more common in older adults, but doctors say even children get shingles.
Shingles is caused by varicella zoster virus , the same virus that causes chickenpox. After a person recovers from chickenpox, the virus stays dormant in their body. The virus can reactivate later, causing shingles.
“Not everyone who had chickenpox will develop shingles,” Wigand-Bolling noted.
Two other things to keep in mind: You cannot get shingles from someone who has shingles, the CDC says. However, you can get chickenpox from someone who has shingles if you’ve never had chickenpox or never received the chickenpox vaccine.
What Is Postherpetic Neuralgia
Sometimes, particularly in older people, shingles pain persists long after the rash has healed. This is postherpetic neuralgia, defined as pain lasting three months after onset of the rash. Pain can be mild or severethe most severe cases can lead to insomnia, weight loss, depression, and disability. There may be other sensations, such as tingling, coldness, or loss of feeling. About 20 percent of people age 70 or greater who develop shingles may have long-lasting pain. Postherpetic neuralgia is not directly life-threatening and may get better over time.
About a dozen medications in four categories have been shown in clinical trials to provide some pain relief for postherpetic neuralgia. These include:
Tricyclic antidepressants : TCAs are often the first type of drug given to people suffering from postherpetic neuralgia. The TCA amitryptiline was commonly prescribed in the past, but although effective, it has a high rate of side effects. Desipramine and nortriptyline have fewer side effects and are therefore better choices for older adults, the most likely group to have postherpetic neuralgia.
Common side effects of TCAs include dry eyes and mouth, constipation, and impaired memory. People with heart arrhythmias , previous heart attacks, or narrow angle glaucoma should usually use a different class of drugs.
Postherpetic itch
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Get Shingles Treatment Online
Speak to a board-certified doctor securely from your phone or computer and get medication for shingles in 15 minutes. Shingles, also known as herpes zoster, is a viral infection that causes a painful rash. Although shingles can appear anywhere on the body, it most often is a single stripe of blisters that wraps around the left or right side of your torso. With our same-day treatment service, you can meet with a top online doctor, get diagnosed, and receive the medication you need.
How Do Dermatologists Diagnose Shingles
A dermatologist can often diagnose shingles by looking at the rash on your skin.
If there is any question about whether you have shingles, your dermatologist will scrape a bit of fluid from a blister. This will be sent to a lab where a doctor will look at the fluid under a high-powered microscope.
When you have shingles, the fluid contains the virus that causes shingles. Seeing the virus confirms that you have shingles.
Your dermatologist will also ask about your symptoms. Shingles tends to be painful.
When the shingles rash spreads to an eye, it can affect your eyesight
You can reduce this risk by seeing an ophthalmologist immediately.
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What Are The Symptoms Of Shingles On The Scalp
If you have shingles on the scalp, there are specific symptoms that youre bound to notice:
How Long Will The Effects Last
The rash from shingles will heal in 1 to 3 weeks and the pain or irritation will usually go away in 3 to 5 weeks. When shingles occurs on the head or scalp, the symptoms usually go away eventually, but it may take many months.
If the virus damages a nerve, you may have pain, numbness, or tingling for months or even years after the rash is healed. This is called postherpetic neuralgia. This chronic condition is most likely to occur after a shingles outbreak in people over 50 years old. Taking antiviral medicine as soon as the shingles is diagnosed may help prevent this problem.
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How To Prevent Transmission
You cant catch shingles, and you cant give shingles to someone else. But you can give others chickenpox.
After you have chickenpox, the varicella-zoster virus stays dormant in your body. If this virus reactivates, shingles occurs. Its possible to transmit this virus to others who arent immune while the shingles rash is still active. You are contagious to others until all areas of the rash are dried up and crusted over.
To catch the varicella-zoster virus from you, a person has to have direct contact with your rash blisters.
You can help prevent your transmission of the varicella-zoster virus by:
- keeping the rash loosely covered
- practicing frequent handwashing
- avoiding contact with people who may not have had chickenpox or who havent been vaccinated against chickenpox
Last medically reviewed on August 24, 2017
10 sourcescollapsed
- Cohen KR, et al. . Presentation and management of herpes zoster in the geriatric population.
Can Shingles Be Prevented
There are 2 vaccines available to reduce the likelihood of developing shingles, Zostavax and Shingrix. If you are over 50, you can talk to your doctor about whether you need it. It is recommended for everyone over 60 and is given free of charge in Australia to people aged 70 to 79.
Vaccination will not guarantee that you will not get shingles, but it will reduce your chance of developing the condition. The vaccine used to protect against shingles is not the same as the vaccine used to protect against chickenpox. Read more about the chickenpox vaccine here.
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Can I Get Shingles More Than Once
You may have heard that if youve already had chickenpox once, you cant get it again. It might make sense, then, to assume that the same goes for shingles. After all, its the same virus, right?
However, its a misconception. First of all, you can develop chickenpox a second time if youve already had it once. Its quite rare, but it is indeed possible.
Secondly, shingles arent the same as chickenpox. Even though the same virus is responsible for both conditions, they are entirely different. Getting shingles a second time isnt as rare as getting chickenpox twice. When your bout of shingles goes away, the virus goes back into hibernation. This means that it has the potential to become active again later in your life.
In the first few years after your first bout of shingles, the chances of getting it again are slim. In fact, the chance of developing shingles again is lower than it is for someone who has never had it. As the years go on, the odds go up again. Eventually, you have about the same chance of developing shingles as everyone else.
Luckily though, it is extremely rare to develop shingles a third time.
Are There Home Remedies For Treating Shingles
Although shingles will usually go away on its own once it has run its course and the scabs have healed, you can take steps at home to help alleviate pain and discomfort.
Some home remedies for treating shingles include:
- taking cool oatmeal baths
- applying calamine lotion to soothe your skin
- applying cool compresses to the blisters
- wearing loose clothing made from cotton or linen
When possible, try also doing activities that help take your mind off the pain. These activities can include watching a TV series, reading a book, listening to music, or talking with a friend.
Telling a family member or friend about how the pain is affecting you can also help.
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